|
Abstract To explore the value of serum free fatty acid (FFA), pregnancy-associated plasma protein A (PAPP-A), kidney injury molecule -1 (Kim-1), and neutrophil gelatinase-associated lipocalin (NGAL) of women with gestational diabetes mellitus (GDM) for diagnosing their early impaired renal function. Methods: 124 pregnant women with GDM were divided into group A (83 women with normal renal function) and group B (41 women with impaired renal function) according to their endogenous creatinine clearance rate (Ccr) value from January 2019 to January 2020. In addition, 60 healthy pregnant women were selected in group C during the same period. The levels of serum FFA, PAPP-A, Kim-1, and NGAL of the women in the three groups were observed, and their value for diagnosing early renal function injury of the women with GDM was analyzed. Results: The serum FFA, KIM-1 and NGAL levels of the women in group B were significant higher than those of the women in group A, and which both in group B and in group A were significant higher than those of the women in group C. The serum PAPP-A level of the women in group B was significant lower than that of the women in group A, and which both in group B and in group A was significant higher than that of the women in group C (P＜0.05). The FFA level was positive correlated with the KIM-1 and NGAL levels (r=0.674, 0.712, P＜0.01), and which was negative correlated with the PAPP-A level (r=-0.648, P＜0.01). The level of PAPP-A was negative correlated with the levels of KIM-1 and NGAL (r=-0.711, 0.754, P＜0.01), and the level of KIM-1 was positive correlated with the level of NGAL (r=0.731, P＜0.01). The optimal cut-off value of the FFA level, the PAPP-A level, the KIM-1 level, or the NGAL level for diagnosing early impaired renal function of the women with GDM was >1.2mmol/L, ≤4.5U/L, ≥7.0 ng/mL, or >55.9 ug/L, which’s sensitivity was 74.5%, 85.1%, 78.4%, or 87.1%, which’s specificity was 86.4%, 87.2%, 95.6%, or 87.1%, and which’s AUC was 0.840, 0.901, 0.887, or 0.891. The value of serum FFA level, Kim-1 level or NGAL level for diagnosing early impaired renal function of the women with GDM was significantly higher than that of the FFA level. Conclusion: Serum FFA, PAPP-A, Kim-1 and NGAL levels are helpful to the clinical screening early impaired renal function of the women with GDM, especially PAPP-A, Kim-1 and NGAL levels have higher sensitivity and specificity.
|
